Ozgürdal Seza, Gudlowski Yehonala, Witthaus Henning, Kawohl Wolfram, Uhl Idun, Hauser Marta, Gorynia Inge, Gallinat Jürgen, Heinze Martin, Heinz Andreas, Juckel Georg
Department of Psychiatry, Ruhr University Bochum, LWL University Hospital, Germany.
Schizophr Res. 2008 Oct;105(1-3):272-8. doi: 10.1016/j.schres.2008.05.017. Epub 2008 Jul 14.
Neurophysiological methods allow the examination of cognitive-cortical functioning in patients with schizophrenia in its prodromal states. As revealed by previous studies, event-related potential components such as auditory evoked P300 associated with cognitive processes, such as attention and orientation, are known to be reduced in amplitude in acute and chronic as well as in medicated and unmedicated patients. It is, however, unclear whether a P300 amplitude reduction occurs before the schizophrenic psychosis is fully manifested. We studied patients in the prodromal phase of the schizophrenic disorder (i.e. subjects with an at-risk mental state showing attenuated psychotic symptoms or brief limited intermittent symptoms) as well as first-episode patients and chronic patients with schizophrenia and compared these groups to healthy subjects. The event-related P300 was recorded during an auditory oddball paradigm. Groups differed significantly from each other in the P300 amplitude at Pz (F(3/149)=2.532, p=0.02). Post-hoc tests revealed significantly lower P300 amplitudes of non-medicated prodromal (p=.03), first-episode (p=.01) and chronic patients (p=.001) compared to the healthy controls. The study revealed that there are neurophysiological changes as the reduction in P300 amplitudes begins early in schizophrenia at the prodromal phase, i.e. before a manifestation of full-blown psychosis, and that these changes seem to have a progressive course from prodromal to chronic state of schizophrenia as assumed in this cross-sectional study.
神经生理学方法可用于检查精神分裂症前驱期患者的认知皮层功能。既往研究表明，与注意力和定向等认知过程相关的事件相关电位成分，如听觉诱发P300，在急性和慢性患者以及服药和未服药患者中，其波幅均降低。然而，尚不清楚P300波幅降低是否发生在精神分裂症精神病完全显现之前。我们研究了精神分裂症前驱期患者（即有高危精神状态、有减弱的精神病性症状或短暂有限间歇性症状的受试者）以及首发患者和慢性精神分裂症患者，并将这些组与健康受试者进行比较。在听觉oddball范式期间记录事件相关P300。各组在Pz处的P300波幅存在显著差异（F(3/149)=2.532，p=0.02）。事后检验显示，与健康对照组相比，未服药的前驱期患者（p=0.03）、首发患者（p=0.01）和慢性患者（p=0.001）的P300波幅显著更低。该研究表明，存在神经生理学变化，因为P300波幅降低在精神分裂症前驱期就已开始，即在全面性精神病显现之前，并且正如本横断面研究所假设的，这些变化似乎从精神分裂症前驱期到慢性期呈渐进过程。
